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Will a Breast MRI Always Find Silicone Rupture or Extracapsular Towards Armpit?

asked 1 year ago by moodymummy in UNITED KINGDOM
Latest answer by Farhad Rafizadeh, MD
Question viewed 697 times
Tags: MRI, rupture

I have had my silicone implants for 9 years. They are behind the muscle. There have been some subtle changes in the sizes and shapes of both breasts, but I put this down to childbearing. In the last year, I have had some intermittent pain, redness and swelling to the right breast, especially in the armpit. I was referred for an ultrasound and it apparently showed silicone high in the armpit. The MRI with coils came out clear, but would this type of MRI definitely show that area?

19 answers to Will a Breast MRI Always Find Silicone Rupture or Extracapsular Towards Armpit?

+2

Addressing a positive ultrasound but negative MRI in diagnosing a possible ruptured silicone breast implant

As noted by the other responders, your results are conflicting between the ultrasound and the MRI. Even though the MRI is the most accurate diagnostic technique short of surgery, it is not fool proof and may be associated with around 10% false negatives (that is, it will not identify implant disruption 10% of the time on average). The changes of your breast are most likely totally unrelated to the state of the implant. However, given your symptoms, it would not be unwise to consider... more
Steven Turkeltaub, MD

Scottsdale Plastic Surgeon
+2

MRI detection of silicone gel leakage

MRI is good for detecting leakage of silicone gel implants, but by no means foolproof. Most experienced plastic surgeons have seen many instances of false readings of MRI studies. An experienced plastic surgeon can help you sort out all the tests and make a recommendation based on your physical exam (i.e. tender lymph nodes), the ultrasound (?silicone) and the MRI. Usually lymph nodes that are palpable, abnormal warrant a workup and probable removal. Obviously if... more
Brent Moelleken, MD

Beverly Hills Plastic Surgeon
+2

Will a Breast MRI Always Find Silicone Rupture or Extracapsular Towards Armpit?

If the scan showed free silicone you need exploration and possible explantation of the ruptured implant. Do not follow the results of the MRI. Just from your history I think of a rupture. From MIAMI Dr. Darryl j. Blinski
Darryl J. Blinski, MD

Miami Plastic Surgeon
+2

Nothing is 100%

Hello, MRI is the highest in sensitivity of the available tests for the problem. Then again with the symptoms you are having I probably would have just recommended capsulectomy and implant exchange. This surgery has a good chance of improving your problems rupture or not.   Best Regards,   John Di Saia MD
John P. Di Saia, MD

Orange Plastic Surgeon
+2

You may need implant exchange

You have Multiple symptom that are consistent with ruptured implant. If you get MRI and it is negative you will need implant exchange because of the silicone in Scilla and also your symptoms. The other possibilty is silicone gel is leaking from the implant without gross rupture.
Kamran Khoobehi, MD

New Orleans Plastic Surgeon
+2

Breast MRI

Breast MRI is 90% accurate. When looking at large groups of women, MRI is a better test than breast ultrasound if you are trying to determine if a silicone gel implant is leaking. Physical examination is only about 30% accurate.  Accuracy is important when evaluating groups of people. On an individual basis, the accuracy of a test can be reassuring, however for the individual one in ten test results are wrong. The only "test" better than an MRI in this situation is... more
Joseph Mele, MD

Walnut Creek Plastic Surgeon
+2

MRI for Ruptured Silicone Implant

I would have to defer to a Radiologist for an absolute answer to your question.  MRIs are not 100% accurate in demonstrating a ruptured silicone implant.  However, I would be surprised if an MRI would not demonstrate an extracapsular extravasation of silicone into your axilla.
John Whitt, MD

Louisville Plastic Surgeon
+2

MRI is not 100% accurate in detecting implant rupture

I have had patients with ruptured silicone breast implants that have had negative MRI studies.  The MRI is the most accurate diagnostic test , but it has to be used in conjunction with clinical and historical evaluation to be helpful in the decision making process.
Dev Wali, MD

Los Angeles Plastic Surgeon
+2

MRI and breasts

The MRI is the most reliable study to determine whether or not an implants is ruptured. It is the gold standard.
Steven Wallach, MD

Manhattan Plastic Surgeon
+2

Will a Breast MRI Always Find Silicone Rupture or Extracapsular Towards Armpit?

MRI are currently the BEST non-invasive method to detect implant rupture but they are far from perfect and data show that they are only about 89% accurate. This means that in more than 1 0ut of 10 patients the diagnosis will be wrong.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Positive ultrasound, negative MRI. Do I have a ruptured implant?

Both MRI and ultrasound are tests that should false results or be misread. They don't replace the judgment of an expert. I would consult an experienced plastic surgeon. He would normally review the tests and also find out why you have redness and swelling in the armpit. He should then review the tests with a radiologist and decide what to do, based on all the information.
Farhad Rafizadeh, MD

Morristown Plastic Surgeon
+1

MRI and ultrasound

This is a tough one.  MRI is very accurate for implant rupture and if the implants are intact, you probably don't have silicone in your axilla.  I would have your radiologists discuss your case with each other and a plastic surgeon who has examined you carefully.    The other issue is if your implants are ruptured and you do have some silicone in your axilla, it may be unwise to have anyone go after it unless your nodes are enlarged and sore.  The axilla is a... more
Lisa L. Sowder, MD

Seattle Plastic Surgeon
+1

Will a Breast MRI Always Find Silicone Rupture or Extracapsular Towards Armpit?

MRI is a very good diagnostic tool, but as the other surgeons have said it can miss extracapsular rupture. I completely agree that you need surgery to remove the implants and extracapsular silicone. Best of luck.
Kenneth Bermudez, MD

San Francisco Plastic Surgeon
+1

An MRI is better able to detect a rupture breast implant than an ultrasound.

Because the tests are not always 100% accurate and also because you have 2 tests with conflicting results, it best to visit a board-certified surgeon. Explain the current symptoms you are experiencing as swelling and redness are not normal and need to be addressed as soon as possible.
Sam Speron, MD

Chicago Plastic Surgeon
+1

MRI scan is accurate about 90% of the time in detecting breast implant gel rupture.

MRI scans are the best non-surgical test we have to detect implant failure.  Still, they're wrong about 10% of the time and this inaccuracy rate needs to be factored in to clinical decision making.
Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon
+1

Implant Exchange Is Next Step With MRI Detection Of Rupture

The MRI examination is the best test we have to detect breast implant rupture  but it is not always 100% accurate. But given your breast symptoms, I would assume that the MRI is correct and proceed with implant exchange. It would be different if this was an incidental finding and the breast felt fine. But your breast symptoms are suspicious for implant rupture and the MRI finding confirms the need for breast implant replacement surgery.
Barry L. Eppley, MD, DMD

Indianapolis Plastic Surgeon

www.eppleyplasticsurgery.com

+1

Ruptured silicone implant detection

The MRI is the most accurate tool we have but like everything else it's not fullproof.  If you have another exam that is detecting silicone in your axillary region and the implants seem to have changed clinically then it may be time for an exchange.  Look into your implants to see if you have a guarantee, many do.
Ricardo A. Meade, MD

Dallas Plastic Surgeon
+1

MRI and ruptured implant

Hi MoodyMummy, MRI is a very sensitive test, as the other doctors have pointed out.  However, it is not 100% accurate.  I assume a specialized, experienced breast radiologist read the MRI study.  If not, I would have such a person review the study.  It is helpful for the surgeon to know if the implant is ruptured prior to surgery.   Regardless of what the MRI shows, I suggest you consult with your plastic surgeon and possibly a breast surgeon regarding... more
Tracy Pfeifer, MD

Manhattan Plastic Surgeon

drpfeifer.com

+1

Possible Leaking Breast Implant

Regarding: "Will a Breast MRI Always Find Silicone Rupture or Extra capsular Towards Armpit? I have had my silicone implants for 9 years. They are behind the muscle. There have been some subtle changes in the sizes and shapes of both breasts, but I put this down to childbearing. In the last year, I have had some intermittent pain, redness and swelling to the right breast, especially in the armpit. I was referred for an ultrasound and it apparently showed silicone high in the armpit.... more
Peter A. Aldea, MD

Memphis Plastic Surgeon

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